Under the Affordable Care Act (ACA), health insurance coverage must include breastfeeding equipment, but did you know it also provides counseling and support for the duration of breastfeeding? The only health insurance plans exempt from these rules are grandfathered plans—insurance that was effective prior to March 23, 2010. If you are denied coverage for a breast pump, under the ACA you have the right to an internal appeal and external appeal, and you should contact your state’s Department of Insurance for assistance.
Purchasing power. Your health insurance plan must cover the cost of a breast pump, either a rental or a new model and may have guidelines about whether the pump is manual or electric, how long the coverage of a rented pump lasts, and when the pump will be provided to you.
Before you make any purchasing decisions, you should contact your insurance provider so that you are educated about all of your options. It is also important to contact your provider beforehand, because some plans require a prescription or pre-authorization from a doctor before you can be covered for a breast pump.
Work/Life balance. While breastfeeding and returning to the workforce might seem like a difficult combination, the law is on your side. The ACA amended the Fair Standards Labor Act (FLSA), which covers the majority of hourly employees and some salaried employees. Under the amended FSLA, employers are required to provide their nursing employees two benefits: women must be given a “reasonable time” for breast pumping for up to one year after a child’s birth; and women must be provided a private space for pumping, and that private space cannot be a bathroom.
Long-term support. If you need help with breastfeeding or counseling, you should contact your health insurance company for a list of providers whose services include lactation support. The U.S. Department of Health & Human Services also has a toll-free number, 800.994.9662, that you can call to speak to a trained breastfeeding counselor in either English or Spanish. This hotline is for general questions, such as breast-pump cleaning and milk storage.